Abstract
Background:
Recent data have suggested an increased risk of stroke with the utilization of Impella 5.5 (Abiomed, Danvers, MA, USA) devices for bridging Status 2 heart transplant patients. The purpose of our study was to investigate the relationship between the duration of Impella 5.5 support and the incidence of stroke after heart transplant.
Methods:
An analysis of the UNOS database was performed on heart transplant recipients that were bridged with an Impella 5.5 from January 2022 to March 2025. Patients were divided into two cohorts according to duration of support (<30 and >30 days). A propensity score matched adjustment model was used to ascertain stroke probabilities across analyzed groups.
Results:
A total of 1580 patients that received an Impella 5.5 as a bridge to heart transplant were identified, of which 1186 (75%) were supported for <30 days and 394 (25%) >30 days. Age, male sex, previous cardiac surgery, higher BMI and functional status at listing were significant factors for the occurrence of stroke in both groups (<30 and >30 days). Propensity score matched stroke rate in the <30-day cohort was 3.5% and in the >30-day group was 6.2% (p = 0.043). In patients with post-transplant stroke, pre-transplant history of stroke was present in 22.4% of patients supported <30 days and 19% of patients on Impella for >30 days.
Conclusions:
Prolonged duration of support, in excess of 30 days, with an Impella 5.5 is associated with a significantly higher risk of stroke after heart transplantation.
Get full access to this article
View all access options for this article.